Risk factors for electrocardiographic left ventricular hypertrophy in a young Chinese general population: the Hanzhong adolescent cohort study.

BACKGROUND: Electrocardiographic left ventricular hypertrophy (ECG-LVH) is a common manifestation of preclinical cardiovascular disease. The present study aimed to investigate risk factors for ECG-LVH and its prevalence in a cohort of young Chinese individuals. METHODS: (1) A total of 1515 participants aged 36-45 years old from our previously established cohort who were followed up in 2017 were included. Cross-sectional analysis was used to examine risk factors for ECG-LVH and its prevalence. (2) A total of 235 participants were recruited from the same cohort in 2013 and were followed up in 2017. Longitudinal analysis was used to determine the predictors of LVH occurrence over the 4-year period. We used multivariable logistic regression models to calculate OR and 95% CIs and to analyze risk factors for ECG-LVH. RESULTS: In the cross-sectional analysis, the prevalence of LVH diagnosed by the Cornell voltage-duration product in the overall population and the hypertensive population was 4.6% and 8.8%, respectively. The logistic regression results shown that female sex [2.611 (1.591-4.583)], hypertension [2.638 (1.449-4.803)], systolic blood pressure (SBP) [1.021 (1.007-1.035)], serum uric acid (SUA) [1.004 (1.001-1.006)] and carotid intima-media thickness (CIMT) [67.670 (13.352-342.976)] were significantly associated with the risk of LVH (all P < 0.05). In the longitudinal analysis, fasting glucose [1.377 (1.087-1.754)], SBP [1.046 (1.013-1.080)] and female sex [1.242 (1.069-1.853)] were independent predictors for the occurrence of LVH in the fourth year of follow-up. CONCLUSIONS: Our study suggested that female sex, hypertension, SBP, SUA and CIMT were significantly associated with the risk of LVH in young people. In addition, fasting glucose, SBP and female sex are independent predictors of the occurrence of LVH in a young Chinese general population.

Risk factors for subclinical renal damage and its progression: Hanzhong Adolescent Hypertension Study.

BACKGROUND/OBJECTIVES: Chronic kidney disease (CKD) is a global public health problem, including in China. The aim of this study was to identify the risk factors for the development and progression of subclinical renal disease (SRD) in a Chinese population. We also examined whether the impact of the risk factors on SRD changed over time. SUBJECTS/METHODS: To identify the predictors of SRD, we performed a cross-sectional study of the 2432 subjects in our Hanzhong Adolescent Hypertension Cohort. A subgroup of 202 subjects was further analyzed over a 12-year period from 2005 to 2017 to determine the risk factors for the development and progression of SRD. RESULTS: In cross-sectional analysis, elevated blood pressure, male gender, diabetes, body mass index, and triglyceride were independently associated with a higher risk of SRD. In longitudinal analysis, an increase in total cholesterol over a 4-year period and an increase in serum triglyceride over a 12-year period were independently associated with progression of albuminuria. Finally, increases in both total cholesterol and serum uric acid over a 4-year follow-up showed an independent association with a modest reduction in estimated glomerular filtration rate (eGFR). CONCLUSIONS: In this study of a Chinese cohort, we show several metabolic abnormalities as independent risk factors for subclinical renal disease in a Chinese cohort. In addition, we demonstrate that the effects of total cholesterol, triglycerides and uric acid on the development and progression of albuminuria or the decline in eGFR vary at different points of follow-up. These findings highlight the importance of early detection of metabolic abnormalities to prevent SRD.

Association of uric acid in serum and urine with subclinical renal damage: Hanzhong Adolescent Hypertension Study.

BACKGROUND AND OBJECTIVES: The aim of the study was to examine the associations of uric acid (UA) in blood and urine with subclinical renal damage (SRD) and its progression in a Chinese cohort. METHODS: 1) 2342 participants from our previously established cohort who were followed up in 2017 were included. Cross-sectional analysis was used to examine the relationships between serum and urinary UA and the risk of SRD. 2) A total of 266 participants were recruited from the same cohort in 2013, and followed up in 2017. Longitudinal analysis was used to determine the relationships of serum and urinary UA with progression of SRD, which was defined as urinary albumin-to-creatinine ratio (uACR) progression or estimated glomerular filtration rate (eGFR) decline. RESULTS: In cross-sectional analysis, higher levels of uACR were associated with higher levels of serum uric acid (SUA) and urinary uric acid/creatinine ratio (uUA/Cre). Lower eGFR was associated with higher levels of SUA and fractional excretion of uric acid (FEUA) but lower uUA/Cre levels in all subjects. In addition, the multivariate-adjusted odds ratios for SRD compared with non-SRD were 3.574 (2.255-5.664) for uUA/Cre. Increasing uUA/Cre levels were associated with higher risk of SRD. In longitudinal analysis, 4-year changes of uUA/Cre and SUA were significantly associated with eGFR decline. CONCLUSIONS: This study suggested that urinary UA excretion was significantly associated with the risk of SRD in Chinese adults. Furthermore, 4-year changes of serum and urinary UA were associated with SRD progression. These findings suggest that UA, especially urinary UA, may be used as a simple, noninvasive marker for early detection of decreased renal function in otherwise healthy subjects.

[Law of Pollutant Erosion and Deposition in Urban Sewage Network].

In order to investigate the scouring and deposition law of pollutants in urban sewer systems, the investigation of sewer systems was carried out in Xi'an. The results showed that the thickness of sediment in the branch pipe and the main pipe varied obviously. At the peak of the drainage, the velocity increased gradually, and the thickness of the pipeline sediment decreased. At the bottom of the drainage trough, the changes of the velocity and the thickness of the pipeline sediment were opposite, with variations of 0-24 mm and 0-12 mm, respectively. And the probability of granular contaminants sedimentation and scouring in sewer systems was high, while the thickness of sediment in sewage main pipe was less than the above mentioned pipes, the variation of which was 0-7 mm. In addition, the sedimentation and scouring in the main pipeline kept relatively balanced and the thickness of sediment remained stable. In order to clarify the relationship between the concentration of pollutants and the flow velocity, a pilot sewer system was established. The effects of different flow rates, which were 0.1, 0.3, 0.6, 0.9, 1.2 m·s-1, respectively, on the contents of carbon (organic), nitrogen and phosphorus in the pipeline were studied. The results showed that with the increase of the flow velocity, the scour intensity increased and the concentration of pollutants in the pipeline also increased sharply. As shown by the monitoring results of the static light scattering particle size analyzer, the carbon organic pollutants in the pipeline were easily adsorbed on the larger particles, while nitrogen and phosphorus pollutants were easily adsorbed on the particles with smaller size. Analysis on the change of the urban sewage pipeline showed, when the flow rate was less than 0.6 m·s-1, the sedimentation of granular pollutants in the sewage was greater than the scouring effect. When the flow velocity was higher than 0.6 m·s-1, the water scouring intensity increased and the scouring action was greater than the sedimentation, meanwhile, the sediments were carried by the water and the thickness of the sediments was reduced. The increase of the organic pollutants in the sewage was bigger than the nitrogen and phosphorus pollutants, so that the existing sewage carbon source was improved.

[Sediment Characteristics of Sewer in Different Functional Areas of Kunming].

The problem of sediment deposition in urban sewer network in different levels, will not only reduce the sewer flow ability, but also release pollutants and generate secondary pollution. The impact of secondary pollution is more serious in the study area, Kunming, because of the combined sewer overflow in rainy season. In order to obtain the characteristics of the sewer sediments in Kunming, the sewer sediments from residential area, service area, cultural district, and business district were investigated and collected. The particle size, density, organic matter (VSS/TSS) and pollutant content of the sediments were analyzed in this study. The results showed that there were different characteristics for the sediments from different areas. The size of the sediments exhibited business district >cultural district >residential area >service area, and the D50 was concentrated in the 20 to 100 µm except the business district. As for VSS/TSS, the order was residential area >cultural district >business district >service area. It was negatively correlated with the dry density with the correlation index of R2=0.9827 and positively correlated with the water content. The contents of sediments showed significant differences in different functional areas. The size of COD presented residential area >cultural district >service area >business district, and the size of TN followed residential area >cultural district >business district >service area. As for TP, it exhibited residential area >service area >cultural district >business district. The COD, TN and TP were proportional to the population density of the area and TP was greatly influenced by sediment particle size. From the branch into the Sub-main sewer, COD and TN were irregular, and TP decreased slightly. TP mainly existed as particulate and was more likely to deposit onto the small particle. As for TN, there was no obvious rule about its distribution in different particle size sections. The pollution load was generally on the high side in Kunming. The content of heavy metals in business district was the highest among all functional areas, and the concentrations of Cu, Zn, Pb, Cd were 284.6, 786.4, 201.2, 2.54 mg·kg-1 respectively. The average contents of Cu, Zn, Pb, Cd in urban area were 2.2, 4.4, 2.5, 8.6 times than the background values. It is suggested to control Cd and Zn with priority.